CMS Formulary

Displaying 133251-133260 of 1611142 results.
ID: 133251
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133252
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133253
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133254
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133255
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133256
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 133257
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133258
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133259
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 133260
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0